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Valgus and Varus Stress Test

Valgus and Varus Stress Test

Name
Purpose
Description
Sensitivity, Specificity
Validity, Reliability
Likelihood Ratio +/-
Valgus Stress Test
An assessment for one-plane medial instability (gapping of the tibia away from the femur on the medial side).[1]
The therapist applies a valgus stress at the knee while the ankle is stabilized in slight lateral rotation either with the hand or with the leg held between the examiner’s arm and trunk. The knee is first in full extension, and then it is slightly (20-30 degrees) so that it is “unlocked”.1
 
Sensitivity
86%[2]
 
 
K=0.16[3]
N/A


[1] Magee DJ. Orthopedic Physical Assessment: 5th Edition. St. Louis, MO: Saunders Elsevier;2008.
 
[2] Harilainen A. Evaluation of Knee Instability in Acute Ligamentous Injuries. Ann Chir Gynaecol. 1987; 76: 269-273.
[3] McClure P,W et al. Intertester reliability of clinical judgements of medial knee ligament integrity. Phys Ther. 1989;69:268-275.

Name
Purpose
Description
Sensitivity, Specificity
Validity, Reliability
Likelihood Ratio +/-
Varus Stress Test
An assessment for one-plane lateral instability (i.e. the tibia moves away from the femur an excessive amount on the lateral aspect of the leg).[1]
 
The therapist applies a varus stress at the knee while the ankle is stabilized. The test is first done with the knee in full extension and then with the knee in 20-30 degrees of flexion. 1
 
Sensitivity
0%[2]-25%[3]
K=0[4]
N/A


[1] Magee DJ. Orthopedic Physical Assessment: 5th Edition. St. Louis, MO: Saunders Elsevier;2008.
[2] Harilainen A et al. Diagnosis of acute knee ligament injuries: The value of stress radiography compared with clinical examination, stability, under anesthesia and arthroscopic or operative findings. Ann Chir Gynaecol. 1986;75:37-43.
[3] Harilainen A. Evaluation of Knee Instability in Acute Ligamentous Injuries. Ann Chir Gynaecol. 1987; 76: 269-273.
[4] Cleland J. Orthopedic Clinical Examination: An Evidence-Based Approach for Physical Therapists. Carlstadt, NJ: Icon Learning Systems; 2005.